NPIMap

Individual provider Active NPI

Jayshree M Desai, MD

  • Internal Medicine Physician
  • Livonia, MI
National Provider Identifier
1396752283
Registry record updated Nov 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301056798 Issued in MI
Practice address
36180 Five Mile Road
Livonia, MI 48154
Phone
(734) 591-7666
Fax
(734) 591-2426
NPI assigned
Aug 2, 2006
Last updated
Nov 29, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301056798 MI Primary

Addresses

Primary practice location

36180 Five Mile Road
Livonia, MI 48154

Mailing address

36180 Five Mile Road
Livonia, MI 48154
Phone (734) 591-7666

Other identifiers 1

IdentifierTypeStateIssuer
3323140MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061005000391 MI Practitioner - Internal Medicine 9931105426 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Great Lakes Physicians PCGroup PAC ID 1355341223, 2 clinicians

Practice addresses (Care Compare)

36180 Five Mile Rd
Livonia, MI 48154-1919
Phone (734) 591-7666

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Great Lakes Physicians PC Internal Medicine CurrentSince Jan 15, 2007 Accepting new patients

Locations

36180 5 Mile Rd
Livonia, MI 48154
Phone (734) 464-7000

36180 5 Mile Rd
Ste A
Livonia, MI 48154
Phone (734) 591-7666

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196294400000",
    "number": "1396752283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36180 FIVE MILE ROAD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "48154",
            "telephone_number": "734-591-7666",
            "fax_number": "734-591-2426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36180 FIVE MILE ROAD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "48154",
            "telephone_number": "734-591-7666",
            "fax_number": "734-591-2426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESAI",
        "first_name": "JAYSHREE",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2007-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301056798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3323140",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

Verify at the official NPI Registry.